JCU - January 2022 - 50

50
Journal of Clinical Urology 15(1)
Table 2. (Continued)
Study
No. of
patients
Lyon
et al.
2015
13
Age (years)
M=67
(SD=8.0)
Follow-up
Median=16.5
months (IQR
14-18.4)
Cause of BNC or VUAS
Radiation
history
RRP (n=5); RALP
(n=3); TURP (n=3);
brachytherapy (n=2)
n=6
(46.2%)
No. of prior BNC
or VUAS treatments
M=2.2
(SD=1.1)
Operative method
Bipolar PK button
electrode or PK
Plasma-CISE at 3, 9 and
12 o'clock to 22-26Fr
Injection site of
MMC
1, 3, 8 and 11
o'clock
Timing of
MMC injection
Incision
prior
to
MMC
injection
Dose of MMC
Size of
urethral
catheter
2 mg of 40%
MMC in N/S
NR
Days
of
IDC
3
No serious
adverse event
and one
mild adverse
event (urinary
retention)
62% success
after one
procedure
and overall
success of
77% after
a mean of
1.3±0.5
procedures
Nagpal
et al.
2014
40
Median=64
(range
50-82)
M=20.5 months
(range 3-55)
RP (n=22); RP plus
radiation (n=7); minimally
invasive prostatectomy
including laser (n=4);
cystoprostatectomy with
neobladder (n=3); TURP
(n=2); radiation therapy
(n=2)
Redshaw
et al.
2014
55
M=64.4
(SD=7.6)
1st procedure
median=9.2
months (IQR
3.8-15.4); 2nd
procedure
median=8.6
months (IQR
3.8-12.6)
RRP (n=25); TURP
(n=12); RALP
(n=8); Radical
cystectomy+neobladder
(n=5); radiotherapy
for prostate cancer
(n=2); proton beam
therapy for prostate
cancer (n=1); simple
prostatectomy (n=1);
pelvic fracture+urethral
distraction defect (n=1)
n=9
(22.5%)
One prior
urethral dilation/
urethrotomy
(n=24); two prior
procedures (n=9);
three or more prior
procedures (n=3)
n=14
(25.5%)
44/55 (80%) of
patients had at
least one failed
previous treatment
for BNC; median
prior bladder neck
releases=1 (IQR
0-8); median prior
dilations=1 (range
0-5)
Cold-knife incision at
2, 4, 8 and 10 o'clock
to 26Fr
At the base of
each incision site,
i.e. 2, 4, 8 and 10
o'clock
Incision
prior to
MMC
injection
0.3-0.4 mg for
strictures <1 cm
at each incision
groove; 0.6-0.8
mg for strictures
1.5-2 cm at each
incision groove;
concentration of
0.3-0.4 mg/mL
Cold-knife incision
(n=30); Collins knife
and electrocautery
(n=16); transurethral
resection of scarred
tissue (n=9); multicentre
trial so surgical
technique varied;
generally, 3 or 4 deep
incisions
At each wound
bed of incision
Incision
prior to
MMC
injection
Total dose
ranged from
0.4 to 10 mg;
concentration
ranged from 0.1
to 1 mg/mL
NR
NR
No serious
adverse events
75% success
after one
procedure
and 87.5%
success
after two
procedures
NR
7
4/55 (7%);
osteitis pubis
requiring
cystectomy
and continent
cutaneous
diversion (n=2);
rectourethral
fistula and
necrosis of
bladder floor
(n=1); extensive
necrosis of
bladder neck
extending to
bladder floor and
trigone causing
prolonged pain
(n=1)
Vanni
et al.
2010
18
Median=65
(range
53-78)
Median=12
months (range
4-26)
RRP (n=11); RALP (n=6);
TURP (n=1)
n=2
(11.1%)
One prior bladder
neck incision (n=8);
two or more
prior bladder neck
incisions (n=10,
M=2.8, range 2-6)
Cold-knife incision (3-4
incisions) to 26Fr
At each wound
bed of incision
Incision
prior to
MMC
injection
Total dose
not reported;
concentration of
0.3-0.4 mg/mL
MMC
18Fr
5-7
No serious
adverse events
and three mild
adverse events;
flu-like symptoms
(n=1); prolonged
perineal
discomfort
resolved before
3-month visit
(n=2)
BNC: bladder neck contracture; VUAS: vesicourethral anastomotic stricture; IQR: interquartile range; RP: radical prostatectomy; ORP: open radical prostatectomy; LRP: laparoscopic radical prostatectomy; EBRT: external beam
radiotherapy; NR: not reported; RRP: retropubic radical prostatectomy; RALP: robot-assisted laparoscopic prostatectomy; TURP: transurethral resection of prostate; N/S: normal saline; IDC: indwelling urethral catheter.
*Reported values for the entire study cohort of 37 patients and not just the 11 patients with BNC.
58% success
after one
procedure
and 75%
after two
procedures
Adverse events
Outcome
71% success
after one
procedure
and 89%
after two
procedures

JCU - January 2022

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